Material and methods:
Parameters that evaluated from patients treated in our department between 1st of January, 2006 and 31st of December, 2009 were age, conditions causing immune deficiency, habits of cigarette or alcohol, the way of perineal hair removal, glucose and HbA1c levels at admission, number of debridement under general anesthesia, results of microbiological studies and antibiotics used. Diagnosis was made with physical examination and the finger test proposed by Andresen. All patients underwent to surgical debridement immediately. Wide spectrum antibiotics and attempt to eliminate the underlying causes were started simultaneously with surgical debridement under general anesthesia.
Results:
Six patients were available regarding the study criteria. The mean age was 46,5 ± 10,4. All patients except one had uncontrolled diabetes. The remaining had hematological malignancy and immune suppression caused by the chemotherapeutics. The hygienic condition of perinea was poor in all. Numbers of debridement under general anesthesia were three, two and one in one, two and three of the patients consecutively. The mean hospital staying was 35 ± 14,9 days. Death due to necrotizing fasciitis was not observed in any cases. Two patients died long after their discharge because of the underlying disease. Necrotizing fasciitis did not relapse in anyone.
Conclusion:
Results derived from the small number of patients show that synchronous and intensive surgical and medical treatments are promising. However, they need to be reevaluated in studies having larger number of cases.a
Keywords: Fournier’s gangrene, necrotizing fasciitis, debridement, immunosuppression